Abstract

The aim of this study was to compare ischemic preconditioning (IPC) with two established methods of myocardial protection, namely cold crystalloid cardioplegia and intermittent cross-clamp fibrillation (ICCF), in coronary artery bypass graft (CABO) surgery. This was a prospective randomised study. Thirty CABO patients were randomised to receive: (a) St Thomas' cardioplegia solution no. 2; (b) ICCF; or (c) IPC (two 3-min periods of ischemia with 2-min of reperfusion). Surgery was performed under standardised conditions by one surgeon (WBP). The primary endpoint was cardiac troponin T release during the first 72 h after surgery. Mean troponin T at 72 h was significantly lower in the IPC group (0.5 mug/l; p=0.05, ANOVA) compared with the cardioplegia and ICCF groups (2.1 and 1.3 mug/l respectively). This suggests that ischemic preconditioning is superior at limiting myocardial necrosis during CABO, but there is no difference between cold crystalloid cardioplegia and intermittent cross-clamp fibrillation. (C) 2002 Published by Elsevier Science Ltd on behalf of The International Society for Cardiovascular Surgery.